Thoracentesis Follow-Up

Teresa’s thoracentesis procedure on 12/14 went smoothly. 

The radiologist removed 1.3 liters (about 5.5 cups) of fluid from around Teresa’s right lung. She recommended that Teresa have the other one done soon (they can’t do both same-day). She will have the second procedure tomorrow (Wednesday, 12/20) morning. Although all of the tests have come back from the first one, they will repeat the testing on the second draw, just to be safe.

There were some pains as her lung re-expanded into the space it was supposed to have been in, and some muscle spasms where the needle and catheter went in.  But, they pains went away in about 2 days, which was the estimate I found on multiple sites.  The needle/catheter hole is VERY small.

With both sides done, T should be able to breathe MUCH better. (And even with only 1 side drained, she was still able to reach 1500 on her incentive spirometer! Dr. Musgrave was impressed.)

All of the lab results were auto-released to the app *except* the cytology. We didn’t find out the answer to whether the fluid was benign or malignant until today.

Dr. Musgrave told us there were NO cancer cells seen in the fluid! (Many happy tears here!)

And it was a day of good news, because prior to that, we learned from her lab work that almost all of her numbers have improved.  While many values are still low (and a few high), they are working their way back to normal. Her kidney function test is on it’s way back up to where it should be. Her creatinine is completely back in the normal range.

We’re hoping that this all indicates that the worst of the problems with her labs were truly induced by the chemo, and not from the cancer, or some other unknown problem. (Anemia aside, since it presented prior to chemo, although we’re told some is definitely chemo-induced.) Dr. Musgrave is still watching for hemolysis (destruction of red blood cells – which has been happening prematurely) but says that has improved as well.  It needs to resolve before Teresa can start a new chemo regimen.

She did try to get in touch with Dr. Nadeem Abu-Rustum at Memorial Sloan Kettering, but he is out until January 2nd. She wants to see if he agrees with starting doxorubicin/olaratumab or if he (and Hensley – the medical oncologist/sarcoma specialist there) would go with another plan. T also really wants to get that second surgery done and is hoping it can happen prior to starting a new chemo track. She would definitely feel a lot better without the tumor there (it is causing abdominal tenderness, and some pain – especially when coughing). 

Before any chemo starts, I would like to be given a clear answer on if it is the next chemo in line, or is it truly the best chemo for T’s situation? I don’t want her to just go down the line of chemo with one bad result after another, if there’s a way to know a specific one would work best.

It definitely sounds like the surgery would happen at MSKCC in NYC. We just don’t know when.

Dr. Musgrave also gave us a CBC order that we can have done in Roanoke next week so we don’t have to travel just to have her blood checked. If her hemoglobin is at least 8, she said that T can wait on a transfusion until the following week. If it’s less than 8, we either need to find a place that can do a transfusion in Roanoke, or come back down to have it done in Bristol.

T has her next appointment with Dr. Musgrave on January 3, 2018. 

Please let us know if you have any questions.

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